Modified Marshall Score

A definition of organ failure in acute pancreatitis


In the 2012 revised Atlanta classification of acute pancreatitis, it is suggested that 3 organ systems should be assessed to define organ failure: respiratory, cardiovascular and renal. Using the modified Marshall scoring system, organ failure is defined as a score of ≥2 for one of these three organ systems.

The modified Marshall scoring system is noted to have the advantages of being simple to administer, having universal applicability across international centres as well as the ability to stratify disease severity easily and objectively


Marshall JC, Cook DJ, Christou NV, et al.

Critical Care Medicine 1995, 23 (10): 1638-52

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1. Respiratory status (PaO₂:FiO₂)

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For non-ventilated patients, the FiO₂ can be estimated from below:

Supplemental 0₂ (l/min) → FiO₂ (%):

Room air → 21%
2 l/min → 25%
4 l/min → 30%
6-8 l/min → 40%
9-10 l/min → 50%

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